scholarly journals Changes in Metabolic Syndrome Status and Risk of Dementia

2020 ◽  
Vol 9 (1) ◽  
pp. 122 ◽  
Author(s):  
Ji Eun Lee ◽  
Dong Wook Shin ◽  
Kyungdo Han ◽  
Dahye Kim ◽  
Jung Eun Yoo ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Blood Pressure ◽  
Alzheimer's Disease ◽  
Metabolic Syndrome ◽  
Vascular Dementia ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Screening Program ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model

This study investigated the effects of changes in metabolic syndrome (MS) status and each component on subsequent dementia occurrence. The study population was participants of a biennial National Health Screening Program in 2009–2010 and 2011–2012 in Korea. Participants were divided into four groups according to change in MS status during the two-year interval screening: sustained normal, worsened (normal to MS), improved (MS to normal), and sustained MS group. Risk of dementia among the groups was estimated from the second screening date to 31 December 2016 using a Cox proportional hazards model. A total of 4,106,590 participants were included. The mean follow-up was 4.9 years. Compared to the sustained normal group, adjusted hazard ratios (aHR) (95% confidence interval) were 1.11 (1.08–1.13) for total dementia, 1.08 (1.05–1.11) for Alzheimer’s disease, and 1.20 (1.13–1.28) for vascular dementia in the worsened group; 1.12 (1.10–1.15), 1.10 (1.07–1.13), and 1.19 (1.12–1.27) for the improved group; and 1.18 (1.16–1.20), 1.13 (1.11–1.15), and 1.38 (1.32–1.44) for the sustained MS group. Normalization of MS lowered the risk of all dementia types; total dementia (aHR 1.18 versus 1.12), Alzheimer’s disease (1.13 versus 1.10), and vascular dementia (1.38 versus 1.19). Among MS components, fasting glucose and blood pressure showed more impact. In conclusion, changes in MS status were associated with the risk of dementia. Strategies to improve MS, especially hyperglycemia and blood pressure, may help to prevent dementia.

Survival in Subcortical Vascular Dementia: Predictors and Comparison to Probable Alzheimer's Disease in a Tertiary Memory Clinic Population

2015 ◽  
Vol 40 (3-4) ◽  
pp. 210-221 ◽  
Author(s):  
Jong Hun Kim ◽  
Seok Min Go ◽  
Sang Won Seo ◽  
Suk Hui Kim ◽  
Juhee Chin ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Family History ◽  
Vascular Dementia ◽  
Proportional Hazards Model ◽  
Late Onset ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Subcortical Vascular Dementia ◽  
History Of

Background: Subcortical vascular dementia (SVaD) is one of the most common dementias, after Alzheimer's disease (AD) dementia. Few survival analyses in SVaD patients have been reported. Methods: The dates and causes of death of 146 SVaD and 725 AD patients were included. We used the Cox proportional hazards model to compare survival between SVaD and AD patients and to explore possible factors related to survival of SVaD patients. Results: The median survival time after the onset of SVaD (109 months) was shorter than that recorded for AD (152 months). The most common cause of death in SVaD was stroke (47.1%). Factors associated with shorter survival in SVaD were late onset, male sex, worse baseline cognition, absence of hypertension and a family history of stroke. Conclusions: Stroke prevention may be important in SVaD treatment because 47.1% of SVaD patients died of stroke. A family history of stroke and absence of hypertension were associated with a shorter survival in SVaD, suggesting the existence of genetic or unknown risk factors.

Levels of Systolic and Diastolic Blood Pressure and Their Relation to Incident Metabolic Syndrome

Cardiology ◽  
2019 ◽  
Vol 142 (4) ◽  
pp. 224-231 ◽  
Author(s):  
Ju Young Jung ◽  
Chang-Mo Oh ◽  
Joong-Myung Choi ◽  
Jae-Hong Ryoo ◽  
Pil-Wook Chung ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Subgroup Analysis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Predictive Ability ◽  
Heart Association ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
The Metabolic Syndrome

Background: Elevated blood pressure (BP) is a component of the metabolic syndrome (MetS), and one third of individuals with hypertension simultaneously have MetS. However, the evidence is still unclear regarding the predictive ability of BP for incident MetS. Methods: In total, 5,809 Koreans without baseline MetS were grouped by baseline systolic (SBP) and diastolic BP (DBP) and monitored for 10 years to identify incident MetS. A Cox proportional hazards model was used to evaluate the HR and 95% CI for MetS according to SBP and DBP. Subgroup analysis was conducted in the normotensive population based on a new guideline of the American College of Cardiology and the American Heart Association. Results: High-BP groups tended to have worse metabolic profiles than the lowest-BP group in both SBP and DBP categories. In all of the participants, elevated SBP and DBP levels were significantly associated with the increased HR for MetS, even after adjusting for covariates. Subgroup analysis for normotensive participants indicated that the HR for MetS increased proportionally to both SBP (<110 mm Hg: reference, 110–119 mm Hg: HR = 1.60 [95% CI 1.40–1.84], and 120–129 mm Hg: HR = 2.12 [95% CI 1.82–2.48]) and DBP levels (<70 mm Hg: reference, 71–74 mm Hg: HR = 1.31 [95% CI 1.09–1.58], and 75–79 mm Hg: HR = 1.51 [95% CI 1.25–1.81]). Conclusion: The risk of incident MetS increased proportionally to baseline SBP and DBP, and this was identically observed even in normotensive participants.

scholarly journals Association of Dietary Prebiotic Consumption with Reduced Risk of Alzheimer’s Disease in a Multiethnic Population

2021 ◽  
Vol 19 ◽  
Author(s):  
Mia Nishikawa ◽  
Adam M. Brickman ◽  
Jennifer J. Manly ◽  
Nicole Schupf ◽  
Richard P. Mayeux ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Daily Intake ◽  
Apoe Genotype ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Race Ethnicity ◽  
Reduced Risk

Objective: This study aimed to investigate the association between dietary prebiotic intake and risk for Alzheimer’s disease (AD). Methods: This longitudinal study includes 1,837 elderly (≥65 years) participants of a multi-ethnic community-based cohort study who were dementia-free at baseline and had provided dietary information from food frequency questionnaires. Total daily intake of fructan, one of the best-known prebiotics, was calculated based on consumption frequency and fructan content per serving of 8 food items. The associations of daily fructan intake with AD risk were examined using a Cox proportional hazards model, adjusted for cohort recruitment wave, age, gender, race/ethnicity, education, daily caloric intake, and APOE genotype. Effect modification by race/ethnicity, APOE genotype, and gender was tested by including an interaction term into the Cox models, as well as by stratified analyses. Results: Among 1,837 participants (1,263 women [69%]; mean [SD] age = 76 [6.3] years), there were 391 incident AD cases during a mean follow-up of 7.5 years (13736 person-years). Each additional gram of fructan intake was associated with 24% lower risk for AD ((95% CI)=0.60-0.97; P =0.03). Additional adjusting for smoking, alcohol consumption, and comorbidity index did not change results materially. The associations were not modified by race/ethnicity, gender, and APOE genotype, although stratified analyses showed that fructan intake was significantly associated with reduced AD risk in Hispanics but not in non-Hispanic Blacks or Whites. Conclusion: Higher dietary fructan intake is associated with a reduced risk of clinical Alzheimer’s disease among older adults.

scholarly journals Mid- and Late-Life Migraine Is Associated with an Increased Risk of All-Cause Dementia and Alzheimer’s Disease, but Not Vascular Dementia: A Nationwide Retrospective Cohort Study

2021 ◽  
Vol 11 (10) ◽  
pp. 990
Author(s):  
Hyun-Joo Lee ◽  
Hyunjae Yu ◽  
Son Gil Myeong ◽  
Kijoon Park ◽  
Dong-Kyu Kim
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vascular Dementia ◽  
Proportional Hazards ◽  
Comparison Group ◽  
Late Life ◽  
Cox Proportional Hazards ◽  
Increased Risk ◽  
Migraine Group ◽  
Prospective Association

We used a nationwide cohort sample of data from 2002 to 2013, representing approximately 1 million patients to investigate the prospective association between migraine and dementia. The migraine group (n = 1472) included patients diagnosed between 2002 and 2004, aged over 55 years; the comparison group was selected using propensity score matching (n = 5888). Cox proportional hazards regression analyses was used to calculate the hazard ratios (HRs). The incidence of dementia was 13.5 per 1000 person-years in the migraine group. Following adjustment for sociodemographic and comorbidities variables, patients with migraine developed dementia more frequently than those in the comparison group (adjusted HR = 1.37, 95% confidence interval [CI], 1.16–1.61). In the subgroup analysis, we found a higher HR of dementia events in male, the presence of comorbidities, and older age (≥65) patients with migraine, compared to those without migraine. Moreover, patients with migraine had a significantly higher incidence of Alzheimer’s disease (adjusted HR = 1.31, 95% CI, 1.08–1.58), but not vascular dementia, than those without migraine. Therefore, our findings suggest that mid- and late-life migraines may be associated with an increased incidence of all-cause dementia and Alzheimer’s disease, but not vascular dementia.

scholarly journals Ambulatory blood pressure profile and stroke recurrence

2021 ◽  
pp. svn-2020-000526
Author(s):  
Jie Xu ◽  
Fei Jiang ◽  
Anxin Wang ◽  
Hui Zhi ◽  
Yuan Gao ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Pressure Profile ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Stroke Recurrence ◽  
Hazards Model ◽  
Significant Difference

ObjectivesTo establish a new ambulatory blood pressure (ABP) parameter (24-hour ABP profile) and evaluated its performance on stroke outcome in ischaemic stroke (IS) or transient ischaemic attack (TIA) patients.MethodsThe prospective cohort consisted of 1996 IS/TIA patients enrolled for ABP monitoring and a 3-month follow-up for stroke recurrence as outcome. Profile groups of systolic blood pressure (SBP) were identified via an advanced functional clustering method, and the associations of the profile groups and conventional ABP parameters with stroke recurrence were examined in a Cox proportional hazards model.ResultsThree discrete profile groups (n=604, 781 and 611 in profiles 1, 2 and 3, respectively) in 24-hour ambulatory SBP were identified. Profile 1 resembled most to the normal diurnal blood pressure pattern; profile 2 also dropped at night, but climbed earlier and with higher morning surge; while profile 3 had sustained higher nocturnal SBP without significant nocturnal SBP decline. The incidence of stroke recurrence was 2.9%, 3.9% and 5.5% in profiles 1, 2 and 3, respectively. After adjustment for covariates, profile 3 was significantly associated with higher risk of stroke recurrence with profile 1 as reference (HR 1.76, 95% CI: 1.00 to 3.09), while no significant difference was observed between profiles 2 and 1 (HR 1.22, 95% CI: 0.66 to 2.25). None of conventional ABP parameters showed significant associations with the outcome.ConclusionsAmbulatory 24-hour SBP profile is associated with short-term stroke recurrence. Profiles of ABP may help improve identification of stroke recurrence by capturing the additive effects of individual ABP parameters.

scholarly journals Glucocorticoid use is associated with an increased risk of hypertension

Rheumatology ◽  
2020 ◽  
Vol 60 (1) ◽  
pp. 132-139
Author(s):  
Ruth E Costello ◽  
Belay B Yimer ◽  
Polly Roads ◽  
Meghna Jani ◽  
William G Dixon
Keyword(s):  
Blood Pressure ◽  
Cumulative Dose ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Incident Hypertension ◽  
Increased Risk

Abstract Objectives Patients with RA are frequently treated with glucocorticoids (GCs), but evidence is conflicting about whether GCs are associated with hypertension. The aim of this study was to determine whether GCs are associated with incident hypertension in patients with RA. Methods A retrospective cohort of patients with incident RA and without hypertension was identified from UK primary care electronic medical records (Clinical Practice Research Datalink). GC prescriptions were used to determine time-varying GC use, dose and cumulative dose, with a 3 month attribution window. Hypertension was identified through either: blood pressure measurements &gt;140/90 mmHg, or antihypertensive prescriptions and a Read code for hypertension. Unadjusted and adjusted Cox proportional hazards regression models were fitted to determine whether there was an association between GC use and incident hypertension. Results There were 17 760 patients in the cohort. A total of 7421 (42%) were prescribed GCs during follow-up. The incident rate of hypertension was 64.1 per 1000 person years (95% CI: 62.5, 65.7). The Cox proportional hazards model indicated that recent GC use was associated with a 17% increased hazard of hypertension (hazard ratio 1.17; 95% CI: 1.10, 1.24). When categorized by dose, only doses above 7.5 mg were significantly associated with hypertension. Cumulative dose did not indicate a clear pattern. Conclusion Recent GC use was associated with incident hypertension in patients with RA, in particular doses ≥7.5 mg were associated with hypertension. Clinicians need to consider cardiovascular risk when prescribing GCs, and ensure blood pressure is regularly monitored and treated where necessary.

scholarly journals P1148THE ASSOCIATION WITH LOWER SYSTOLIC BLOOD PRESSURE AND ALL-CAUSE MORTALITY IN PATIENTS UNDERGOING PERITONEAL DIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Motoyasu Kurahashi ◽  
Kenji Harada ◽  
Hidetoshi Kanai
Keyword(s):  
Blood Pressure ◽  
Multivariate Analysis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Group 4 ◽  
Hazards Model ◽  
All Cause Mortality ◽  
Composite Events

Abstract Background and Aims Previous observational studies have been reported that a U-shaped association between systolic blood pressure (SBP) and mortality in patients undergoing hemodialysis. However, the optimal blood pressure in patients undergoing peritoneal dialysis (PD) remains unclear. Method The present study is observational and conducted in a single center. Four hundred and sixteen patients undergoing PD managed in our hospital from April 2010 to December 2017 were participated in this study. The patients were divided into four groups depended on office SBPs, as follows; group1: SBP &lt;110 mmHg (n=60), group2: SBP 110-139 mmHg (n=187), group3: SBP 140-159 mmHg (n=113) and group4: SBP ≧160 mmHg (n=56). When using the Cox proportional hazards model, group 2 was regarded as a reference. Hypertension was defined as SBP ≧140 mmHg, diastolic blood pressure ≧90 mmHg, or use of any anti-hypertensive drugs. The association between SBP with several outcomes such as the risk of all-cause deaths, cardiovascular events and these composite events were estimated using cox proportional hazards model. Adjusted factors were age, sex, comorbidities, laboratory covariates, left ventricle ejection fraction and medications such as renin-angiotensin system blockades and statins. Results The mean follow-up period was 29.2 months. The prevalence of hypertension was 90.4% (n=376) of all patients. The risk of all-cause deaths with multivariate cox proportional hazards regression analysis was significantly higher in the group 1 (hazard ratio 2.08, 95% CI 1.23-3.51, p=0.006). While the risk of CV events with univariate analysis tended to be higher in group 4, there was no significant association between SBP and the risk of CV events with multivariate analysis. The risk of the composite events with multivariate analysis was significantly higher in group 4 (hazard ratio 1.61, 95% CI 1.01-2.57, p=0.047). Conclusion This study indicated that lower SBP was independently associated with all-cause mortality in patients undergoing PD. Moreover, higher SBP might be involved with composite events.

scholarly journals Grain Subtype and the Combination of Grains Consumed Are Associated with the Risk of Metabolic Syndrome: Analysis of a Community-Based Prospective Cohort

2019 ◽  
Vol 150 (1) ◽  
pp. 118-127 ◽  
Author(s):  
Yunhee Kang ◽  
Kyueun Lee ◽  
Jieul Lee ◽  
Jihye Kim
Keyword(s):  
Metabolic Syndrome ◽  
Prospective Cohort ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Whole Grains ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Community Based ◽  
Refined Grains

ABSTRACT Background Evidence on the prospective association between grain consumption and metabolic syndrome (MetS) is lacking. Objective This study explored the association between grain intake by subtype or various combinations of grain intake and the risk of developing MetS in South Korean adults using data from a community-based prospective cohort study. Methods A total of 5717 participants (2984 men and 2733 women) aged 40–69 y without MetS were followed up for 10 y (2001–2012). Grain consumption was assessed using a semiquantitative FFQ at baseline (2001–2002) and a follow-up examination (2005–2006). A multivariate Cox proportional hazards model was used to examine the risk of incident MetS and its components according to grain consumption (&lt;1, 1 to &lt;3, or ≥3 servings/d) by sex. Results In total, 2218 participants (38.8%) developed MetS. Frequent consumers of whole grains (≥3 servings/d) had a lower risk of incident MetS (men—HR: 0.51; 95% CI: 0.41, 0.63; P  = 0.0001; women—HR: 0.73; 95% CI: 0.60, 0.90; P = 0.0029), whereas frequent consumers of refined grains had a higher risk of incident MetS (men—HR: 1.63; 95% CI: 1.31, 2.03; P &lt; 0.0001; women—HR: 2.25; 95% CI: 1.82, 2.78; P &lt; 0.0001) compared with rare consumers (&lt;1 serving/d). The combination of low whole grains (&lt;2 servings/d) and high refined grains (≥2 servings/d) was associated with a higher risk of MetS than the combination of high whole grains and low refined grains (men—HR: 1.21; 95% CI: 1.04, 1.41; P = 0.012; women—HR: 1.43; 95% CI: 1.23, 1.66; P &lt; 0.0001). Conclusions Higher consumption of whole grains was associated with lower risk of incident MetS, whereas higher refined-grain consumption was associated with a higher risk in a middle-aged and older Korean population.

scholarly journals Evaluation of the association between periodontitis and risk of Parkinson’s disease: a nationwide retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eunkyung Jeong ◽  
Jun-Beom Park ◽  
Yong-Gyu Park
Keyword(s):  
Parkinson’S Disease ◽  
Metabolic Syndrome ◽  
Parkinson's Disease ◽  
South Korea ◽  
Large Scale ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model

AbstractThe objective of this study was to examine the association between periodontitis and risk of incident Parkinson’s disease using large-scale cohort data on the entire population of South Korea. Health checkup data from 6,856,180 participants aged 40 and older were provided by the National Health Insurance Service of South Korea between January 1, 2009, and December 31, 2009, and the data were followed until December 31, 2017. The hazard ratio (HR) of Parkinson’s disease and 95% confidence interval (CI) were estimated using a Cox proportional hazards model adjusted for potential confounders. The incidence probability of Parkinson’s disease was positively correlated with the presence of periodontitis. The HR of Parkinson’s disease for the participants without the need of further dentist visits was 0.96 (95% CI 0.921–1.002); the HR of Parkinson’s disease increased to 1.142 (95% CI 1.094–1.193) for the individuals who needed further dentist visits. Compared to individuals without periodontitis and without metabolic syndrome, the HR of incident Parkinson’s disease gradually increased for individuals with periodontitis, with metabolic syndrome, and with both periodontitis and metabolic syndrome. People with periodontitis and metabolic syndrome had the highest HR of incident Parkinson’s disease, at 1.167 (95% CI 1.118–1.219). In conclusion, a weak association between periodontitis and Parkinson’s disease was suggested after adjusting for confounding factors from the population-based large-scale cohort of the entire South Korean population.

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